Pelvic Organ Prolapse

What is pelvic organ prolapse?

Pelvic organ prolapse is a condition in which the muscles and tissues that support the pelvic organs become stretched, damaged or weakened, causing the organs they support to drop downward or sag. The pelvic organs include the vagina, cervix, uterus, bladder, urethra, small intestines, and rectum. Many women who have had a baby have some degree of pelvic organ prolapse, but it can also occur in women who have never given birth. Most women with pelvic organ prolapse have minor symptoms, if any at all.

Types of pelvic organ prolapse

Cystocele. Bladder drops down into the front (anterior wall) of the vagina; also called dropped bladder

Urethrocele. Urethra drops down and bulges into the vagina

Enterocele. Small intestine drops and pushes into the wall of the vagina

Rectocele. Rectum drops down and bulges into the vagina (also known as posterior wall prolapse)

What causes pelvic organ prolapse?

The main cause of pelvic organ prolapse is injury to the muscles or supporting tissue of the pelvic floor caused by childbirth, particularly vaginal delivery. Other causes of pelvic support problems include:

Aging

Hysterectomy or prior pelvic surgery

Menopause

Intense physical activity

Obesity

Family history

Chronic straining due to constipation

Chronic coughing

What are the symptoms of pelvic organ prolapse?

Many women have no symptoms at all. Pelvic organ prolapse may only be detected during their pelvic exam. For those who do have symptoms, they may include:

Pelvic pressure that worsens with standing, lifting, coughing or as the day passes

How is pelvic organ prolapse diagnosed?

Diagnosing the exact cause of pelvic organ prolapse is critical to successful treatment. Proper diagnosis starts with a detailed medical history and a thorough physical exam, including both pelvic and rectal exam. Pelvic organ prolapse can usually be diagnosed by observation of the vaginal walls and cervix. You may be asked to strain or cough during the exam. Bladder function may also be tested.

How is pelvic organ prolapse treated?

Treatment will depend on the type and degree of prolapse, your age, and other factors. Treatment options include:

Observation. Through regular exams, for those women with no symptoms or problems.

Lifestyle changes. Such as dietary changes to address constipation or obesity.